Christmas Door Hanger Paint Party
Please complete this form to begin your registration for the Christmas Door Hanger Paint Party. 

Registration is not complete until the payment of $55.00 is received in full.  Checks may be mailed to Black River Technical College, Community Education, P.O. Box 468, Pocahontas, AR 72455.  

Payments may also be submitted by phone at 870-248-4180.   
A 3% fee will be applied to all credit card payments, resulting in a charge of $56.65. 

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Email *
First Name *
Last Name *
Mailing Address  
(Example: 1234 Test Way)
 *
City, State, & Zip Code 
(Example: Pocahontas, AR 72455)
 *
Date of Birth *
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Sex: *
Phone Number (Ex: (555-555-5555) *
Email Address *
Style of Door Hanger to Paint
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How did you hear about this class? *
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